Determinants of antenatal care attendance among women in Akabiluru District: A cross-sectional study
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Abstract
Antenatal care (ANC) is essential for the early detection of pregnancy complications and the preparation for safe childbirth. Despite national targets of 90% coverage for the fourth ANC visit (K4) and 80% for the sixth ANC visit (K6), ANC utilization in Akabiluru District remains below these standards. In 2024, K4 and K6 coverage reached only 65.2% and 67.6%, respectively, at Piladang Primary Health Center, while Batu Hampar Primary Health Center reported lower rates of 42.0% and 36.0%. This study aimed to identify factors associated with ANC visits among women in Akabiluru District. A descriptive quantitative study with a cross-sectional design was conducted among 48 postpartum mothers within two months after delivery, selected through total sampling. Data were collected using structured questionnaires and analyzed using frequency distribution and Chi-square tests. The findings revealed that most respondents were aged 20–34 years (79.2%), multiparous (66.7%), had completed senior high school education (58.3%), and had family incomes below the regional minimum wage (66.7%). More than half of the respondents had low knowledge (58.3%) and did not complete the recommended ANC visits (58.3%). Bivariate analysis showed that attitude (p=0.000), motivation (p=0.001), husband’s support (p=0.008), and access to information media (p=0.000) were significantly associated with ANC visits. Knowledge, healthcare provider support, and socio-cultural factors were not significantly associated. Strengthening health promotion, antenatal education, and family planning programs may improve ANC utilization among pregnant women.
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How to Cite
Meilinda, V., & Darsi, Q. F. (2026). Determinants of antenatal care attendance among women in Akabiluru District: A cross-sectional study. International Journal on Health and Medical Sciences, 4(3), 135–145. https://doi.org/10.35335/healmed.v4i3.702
References
Adedokun, S. T., Uthman, O. A., & Bisiriyu, L. A. (2023). Determinants of partial and adequate maternal health services utilization in Nigeria: analysis of cross-sectional survey. BMC Pregnancy and Childbirth, 23(1), 1–11. https://doi.org/10.1186/s12884-023-05712-4
Agus, Y., & Horiuchi, S. (2012). Factors influencing the use of antenatal care in rural West Sumatra, Indonesia. BMC Pregnancy and Childbirth, 12. https://doi.org/10.1186/1471-2393-12-9
Ahinkorah, B. O., Ameyaw, E. K., Seidu, A. A., Odusina, E. K., Keetile, M., & Yaya, S. (2021). Examining barriers to healthcare access and utilization of antenatal care services: evidence from demographic health surveys in sub-Saharan Africa. BMC Health Services Research, 21(1), 1–16. https://doi.org/10.1186/s12913-021-06129-5
Alibhai, K. M., Ziegler, B. R., Meddings, L., Batung, E., & Luginaah, I. (2022). Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Conflict and Health, 16(1), 1–16. https://doi.org/10.1186/s13031-022-00459-9
Baten, A., Biswas, R. K., Kendal, E., & Bhowmik, J. (2025). Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis. Systematic Reviews, 14(1). https://doi.org/10.1186/s13643-025-02832-0
Chilot, D., Belay, D. G., Ferede, T. A., Shitu, K., Asratie, M. H., Ambachew, S., Shibabaw, Y. Y., Geberu, D. M., Deresse, M., & Alem, A. Z. (2023). Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1035759
Gurara, M. K., Draulans, V., Van Geertruyden, J. P., & Jacquemyn, Y. (2023). Determinants of maternal healthcare utilisation among pregnant women in Southern Ethiopia: a multi-level analysis. BMC Pregnancy and Childbirth, 23(1), 1–16. https://doi.org/10.1186/s12884-023-05414-x
Hanifah, A., Pratomo, H., & Hoang, G. (2018). Husband’s support for their wives in antenatal care visit. Kesmas, 13(1), 8–16. https://doi.org/10.21109/kesmas.v13i1.1565
Hasni, H., Saman, S., Ariyanti, N., Evie, S., & Enggar, E. (2026). Determinants of Antenatal Care Utilization Among Pregnant Women : A Qualitative Study. 15(1), 283–293.
Khatri, R. B., Mengistu, T. S., & Assefa, Y. (2022). Input, process, and output factors contributing to quality of antenatal care services: a scoping review of evidence. BMC Pregnancy and Childbirth, 22(1), 1–15. https://doi.org/10.1186/s12884-022-05331-5
Laksono, A. D., Rukmini, R., & Wulandari, R. D. (2020). Regional disparities in antenatal care utilization in Indonesia. PLoS ONE, 15(2), 1–13. https://doi.org/10.1371/journal.pone.0224006
Laksono, A. D., Wulandari, R. D., Widya Sukoco, N. E., & Suharmiati, S. (2022). Husband’s involvement in wife’s antenatal care visits in Indonesia: What factors are related? Journal of Public Health Research, 11(2). https://doi.org/10.1177/22799036221104156
Mengesha, E. W., Alene, G. D., Amare, D., Assefa, Y., & Tessema, G. A. (2021). Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review. BMC Health Services Research, 21(1), 1–16. https://doi.org/10.1186/s12913-021-07129-1
Moshi, F. V., Kibusi, S. M., & Fabian, F. (2020). Exploring factors influencing pregnant Women’s attitudes, perceived subjective norms and perceived behavior control towards male involvement in maternal services utilization: a baseline findings from a community based interventional study from Rukwa, rural Tanzania. BMC Pregnancy and Childbirth, 20(1), 1–12. https://doi.org/10.1186/s12884-020-03321-z
Negero, M. G., Sibbritt, D., & Dawson, A. (2023). Women’s utilisation of quality antenatal care, intrapartum care and postnatal care services in Ethiopia: a population-based study using the demographic and health survey data. BMC Public Health, 23(1), 1–18. https://doi.org/10.1186/s12889-023-15938-8
Ofori, P. P., Kubuga, K. K., & Louis, D. K. (2023). Factors Influencing Expectant Mothers’ Continued Use of Digital Health Information. Indonesian Journal of Health Administration, 11(2), 231–241. https://doi.org/10.20473/jaki.v11i2.2023.231-241
Paunno, M., Maspaitella, M. J., Tuasela, J. A., Titarsole, C., Talarima, B., Lawalata, I. V., Titarsole, N. N., & Manuhutu, N. (2026). Factors influencing husbands’ participation in antenatal care: A study in Maluku, Indonesia. Health SA Gesondheid, 31, 1–9. https://doi.org/10.4102/hsag.v31i0.3354
Sendy Ayu Mitra Uktutias, Ade Ayu Mitra Ramadita Daluas, Sri Iswati, & Cholichul Hadi. (2021). The Regularity of Antenatal Care through Knowledge of Pregnant Women and Support from Husbands. Indian Journal of Forensic Medicine & Toxicology, 15(4), 2448–2453. https://doi.org/10.37506/ijfmt.v15i4.17072
Setu, S. P., & Majumder, U. K. (2023). A multilevel analysis to determine the factors affecting WHO recommended quantity antenatal care utilizations of pregnant women in Bangladesh. Heliyon, 9(6), e16294. https://doi.org/10.1016/j.heliyon.2023.e16294
Shine, S., Derseh, B., Alemayehu, B., Hailu, G., Endris, H., Desta, S., & Birhane, Y. (2020). Magnitude and associated factors of husband involvement on antenatal care follow up in Debre Berhan town, Ethiopia 2016: A cross sectional study. BMC Pregnancy and Childbirth, 20(1), 1–7. https://doi.org/10.1186/s12884-020-03264-5
Sitepu, F., Tamtomo, D., & Prasetya, H. (2023). Meta-Analysis the Effects of Education, Pregnancy Planning, Husband Support, and Distance to Health Facilities on the Utilization of Antenatal Care Service. Journal of Maternal and Child Health, 8(4), 510–525. https://doi.org/10.26911/thejmch.2023.08.04.12
Thakkar, N., Alam, N., & Saaxena, D. (2022). Factors associated with the utilization of antenatal care services in Indonesia. BMC Public Health, 22(1), 1–12.
Winters, S., Pitchik, H. O., Akter, F., Yeasmin, F., Jahir, T., Huda, T. M. N., Rahman, M., Winch, P. J., Luby, S. P., & Fernald, L. C. H. (2023). How does women’s empowerment relate to antenatal care attendance? A cross-sectional analysis among rural women in Bangladesh. BMC Pregnancy and Childbirth, 23(1), 1–12. https://doi.org/10.1186/s12884-023-05737-9
World Health Organization. (2025). Trends in maternal mortality estimates 2000 to 2023: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. In WHO, Geneva.
Wulandari, R. D., Laksono, A. D., & Rohmah, N. (2021). Urban-rural disparities of antenatal care in South East Asia: a case study in the Philippines and Indonesia. BMC Public Health, 21(1), 1–9. https://doi.org/10.1186/s12889-021-11318-2
Yang, Y., & Yu, M. (2023). Disparities and determinants of maternal health services utilization among women in poverty-stricken rural areas of China: a cross-sectional study. BMC Pregnancy and Childbirth, 23(1), 1–14. https://doi.org/10.1186/s12884-023-05434-7
Agus, Y., & Horiuchi, S. (2012). Factors influencing the use of antenatal care in rural West Sumatra, Indonesia. BMC Pregnancy and Childbirth, 12. https://doi.org/10.1186/1471-2393-12-9
Ahinkorah, B. O., Ameyaw, E. K., Seidu, A. A., Odusina, E. K., Keetile, M., & Yaya, S. (2021). Examining barriers to healthcare access and utilization of antenatal care services: evidence from demographic health surveys in sub-Saharan Africa. BMC Health Services Research, 21(1), 1–16. https://doi.org/10.1186/s12913-021-06129-5
Alibhai, K. M., Ziegler, B. R., Meddings, L., Batung, E., & Luginaah, I. (2022). Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Conflict and Health, 16(1), 1–16. https://doi.org/10.1186/s13031-022-00459-9
Baten, A., Biswas, R. K., Kendal, E., & Bhowmik, J. (2025). Utilization of maternal healthcare services in low- and middle-income countries: a systematic review and meta-analysis. Systematic Reviews, 14(1). https://doi.org/10.1186/s13643-025-02832-0
Chilot, D., Belay, D. G., Ferede, T. A., Shitu, K., Asratie, M. H., Ambachew, S., Shibabaw, Y. Y., Geberu, D. M., Deresse, M., & Alem, A. Z. (2023). Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1035759
Gurara, M. K., Draulans, V., Van Geertruyden, J. P., & Jacquemyn, Y. (2023). Determinants of maternal healthcare utilisation among pregnant women in Southern Ethiopia: a multi-level analysis. BMC Pregnancy and Childbirth, 23(1), 1–16. https://doi.org/10.1186/s12884-023-05414-x
Hanifah, A., Pratomo, H., & Hoang, G. (2018). Husband’s support for their wives in antenatal care visit. Kesmas, 13(1), 8–16. https://doi.org/10.21109/kesmas.v13i1.1565
Hasni, H., Saman, S., Ariyanti, N., Evie, S., & Enggar, E. (2026). Determinants of Antenatal Care Utilization Among Pregnant Women : A Qualitative Study. 15(1), 283–293.
Khatri, R. B., Mengistu, T. S., & Assefa, Y. (2022). Input, process, and output factors contributing to quality of antenatal care services: a scoping review of evidence. BMC Pregnancy and Childbirth, 22(1), 1–15. https://doi.org/10.1186/s12884-022-05331-5
Laksono, A. D., Rukmini, R., & Wulandari, R. D. (2020). Regional disparities in antenatal care utilization in Indonesia. PLoS ONE, 15(2), 1–13. https://doi.org/10.1371/journal.pone.0224006
Laksono, A. D., Wulandari, R. D., Widya Sukoco, N. E., & Suharmiati, S. (2022). Husband’s involvement in wife’s antenatal care visits in Indonesia: What factors are related? Journal of Public Health Research, 11(2). https://doi.org/10.1177/22799036221104156
Mengesha, E. W., Alene, G. D., Amare, D., Assefa, Y., & Tessema, G. A. (2021). Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review. BMC Health Services Research, 21(1), 1–16. https://doi.org/10.1186/s12913-021-07129-1
Moshi, F. V., Kibusi, S. M., & Fabian, F. (2020). Exploring factors influencing pregnant Women’s attitudes, perceived subjective norms and perceived behavior control towards male involvement in maternal services utilization: a baseline findings from a community based interventional study from Rukwa, rural Tanzania. BMC Pregnancy and Childbirth, 20(1), 1–12. https://doi.org/10.1186/s12884-020-03321-z
Negero, M. G., Sibbritt, D., & Dawson, A. (2023). Women’s utilisation of quality antenatal care, intrapartum care and postnatal care services in Ethiopia: a population-based study using the demographic and health survey data. BMC Public Health, 23(1), 1–18. https://doi.org/10.1186/s12889-023-15938-8
Ofori, P. P., Kubuga, K. K., & Louis, D. K. (2023). Factors Influencing Expectant Mothers’ Continued Use of Digital Health Information. Indonesian Journal of Health Administration, 11(2), 231–241. https://doi.org/10.20473/jaki.v11i2.2023.231-241
Paunno, M., Maspaitella, M. J., Tuasela, J. A., Titarsole, C., Talarima, B., Lawalata, I. V., Titarsole, N. N., & Manuhutu, N. (2026). Factors influencing husbands’ participation in antenatal care: A study in Maluku, Indonesia. Health SA Gesondheid, 31, 1–9. https://doi.org/10.4102/hsag.v31i0.3354
Sendy Ayu Mitra Uktutias, Ade Ayu Mitra Ramadita Daluas, Sri Iswati, & Cholichul Hadi. (2021). The Regularity of Antenatal Care through Knowledge of Pregnant Women and Support from Husbands. Indian Journal of Forensic Medicine & Toxicology, 15(4), 2448–2453. https://doi.org/10.37506/ijfmt.v15i4.17072
Setu, S. P., & Majumder, U. K. (2023). A multilevel analysis to determine the factors affecting WHO recommended quantity antenatal care utilizations of pregnant women in Bangladesh. Heliyon, 9(6), e16294. https://doi.org/10.1016/j.heliyon.2023.e16294
Shine, S., Derseh, B., Alemayehu, B., Hailu, G., Endris, H., Desta, S., & Birhane, Y. (2020). Magnitude and associated factors of husband involvement on antenatal care follow up in Debre Berhan town, Ethiopia 2016: A cross sectional study. BMC Pregnancy and Childbirth, 20(1), 1–7. https://doi.org/10.1186/s12884-020-03264-5
Sitepu, F., Tamtomo, D., & Prasetya, H. (2023). Meta-Analysis the Effects of Education, Pregnancy Planning, Husband Support, and Distance to Health Facilities on the Utilization of Antenatal Care Service. Journal of Maternal and Child Health, 8(4), 510–525. https://doi.org/10.26911/thejmch.2023.08.04.12
Thakkar, N., Alam, N., & Saaxena, D. (2022). Factors associated with the utilization of antenatal care services in Indonesia. BMC Public Health, 22(1), 1–12.
Winters, S., Pitchik, H. O., Akter, F., Yeasmin, F., Jahir, T., Huda, T. M. N., Rahman, M., Winch, P. J., Luby, S. P., & Fernald, L. C. H. (2023). How does women’s empowerment relate to antenatal care attendance? A cross-sectional analysis among rural women in Bangladesh. BMC Pregnancy and Childbirth, 23(1), 1–12. https://doi.org/10.1186/s12884-023-05737-9
World Health Organization. (2025). Trends in maternal mortality estimates 2000 to 2023: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. In WHO, Geneva.
Wulandari, R. D., Laksono, A. D., & Rohmah, N. (2021). Urban-rural disparities of antenatal care in South East Asia: a case study in the Philippines and Indonesia. BMC Public Health, 21(1), 1–9. https://doi.org/10.1186/s12889-021-11318-2
Yang, Y., & Yu, M. (2023). Disparities and determinants of maternal health services utilization among women in poverty-stricken rural areas of China: a cross-sectional study. BMC Pregnancy and Childbirth, 23(1), 1–14. https://doi.org/10.1186/s12884-023-05434-7
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